Background: Necrotising enterocolitis (NEC) and intraventricular hemorrhage (IVH) are the main factors influencing the mortality of newborn babies with extremely low birth weight, that is < 1000 g (ELBW).
Material and methods: Medical records of newborn babies with ELBW (< 1000 g) were subjected to retrospective analysis; group 1. - 92 neonates hospitalized in the Department of Intensive Care and Anaesthesiology of the USK No. 4 UM in Łódź in the years 1991-1993, group 2. - 109 children treated in the same department between 2000 and 2002.
Results: NEC was diagnosed in 41 (45%) out of 92 neonates in group 1., and in 14 (13%) of 109 babies in group 2. Deaths due to NEC were observed in 23 (56%) of 41 newborns with NEC of group 1. and in 6 (42%) of 14 babies with NEC of group 2. In group 2.: the average birth weight was statistically lower (807 vs. 866 g - p < 0.003), the duration of pregnancy was significantly shorter (27 vs. 27.6 week - p < 0.05), the medium APGAR value (2.9 vs. 3.1) and CRIB (8.1 vs. 7.7) were less favorable (NS), congenital infection was more frequent (42% vs. 33% - NS), and RDS was observed less frequently (49% vs. 60% - NS). Pregnancies were terminated by caesarian section more often in group 2. (58% vs. 22%), and while natural delivery was more frequent in group 1., it did not influence the incidence of NEC. Only one neonate of group 1. received Indometacine, while in group 2. it was administered to 7 babies (50%).
Conclusions: Along with the improvement in neonatological care during last 10 years, the frequency of NEC has significantly decreased while the survival rate has increased in newborns with ELBW, in spite of a higher incidence of unfavorable factors such as the shortening of the duration of pregnancy, lower birth weight, and the presence of congenital infection. The method of delivery and the administration of Indometacine did not influence the frequency and results of treatment in the examined groups.